The present invention relates to improved devices, systems and methods for storing and retrieving implants and performing osteotomy procedures.
An osteotomy is a surgical procedure whereby a bone is cut to shorten, lengthen or otherwise change its alignment. It may be performed to correct deformities such as a hallux valgus, a progressive forefoot deformation, or to relieve pain from arthritis, especially in the hip or knee. The procedure usually entails either: the removal of a typically wedge-shaped portion of a bone by cutting transverse to the long axis of the bone, whereupon the bone can be “closed,” i.e., fused together at the space and allowed to heal; or a simple partial cut transverse to the long axis, whereupon the bone can be “opened” and fixated with an appropriate device. For example, an implant may be inserted into the space, and/or a bone plate may be affixed to the bone adjacent to the space, to maintain or increase the space. The “closing” or “opening” changes the spatial relationship between the remaining portions of the bone in order to adjust its alignment or length.
Open-wedge osteotomy refers to a specific type of osteotomy procedure in which a partial cut transverse to the long axis of the bone is made and subsequently opened. The correction is maintained by using an appropriate fixation device, such as, for example, a bone plate with screws. Additionally, a wedge can be included with the bone plate to fill the space that is opened so that the bone can return to a load-bearing state and also to facilitate bone healing. The implanted wedge helps to maintain the opened space by allowing the bone to transmit load to the wedge, thereby preserving the surgeon's aimed reduction or expansion of the angle of the bone before final locking of the plate with bone screws. The wedge also keeps the osteotomy open to allow insertion of locking or non-locking bone screws into the bone to fix the bone plate to the bone.
These procedures have typically been performed using static wedge plates, such as that shown in FIGS. 1A-1D. The static wedge plates shown include a bone plate 2 and a wedge 4 integrally formed on a bottom surface of the plate. The bone plates also include a plurality of holes for the placement of screws. The holes on the bone plate are positioned so that the plate is securable on both sides of an osteotomy 5 as is shown in FIG. 1E, where the static wedge plate is implanted in a foot bone. Proximal to each end, the bone plate 2 further includes a hole adapted for placement of K-wire. U.S. application Ser. No. 14/793,215 (“the '215 application”), the disclosure of which is hereby incorporated by reference herein in its entirety, discloses similar plates wherein a wedge is formed separately from the plate and thereafter assembled thereto. This design allows for the situation of the wedge at varying positions with respect to the plate.
Placement of existing static wedge plates involves orienting the plate such that the integrally formed wedge extends into the resultant space of the bone created by making one or more transverse cuts. This placement may utilize any number of tools or can simply be performed by hand by the surgeon. Placement of a mobile wedge plate like that disclosed in the '215 application is somewhat more difficult. Not only is it necessary to guide the wedge into the resultant space, but it is also necessary to maintain the wedge in position with respect to the plate.
Thus, a need exists to improve the instruments, devices, systems and methods used to perform osteotomy procedures to reduce errors in placement of implants, to reduce the need for additional intraoperative procedures, and to improve storage and retrieval of implants.